Ankilozan Spondilit, Crohn Hastalığı ve Anti-tümör Nekroz Faktör-alfa Tedavi ile İndüklenen Psoriasis olan Hastada Ustekinumab Tedavisine Dramatik Yanıt

Abstract

Treatment with anti-tumour necrosis factor-alpha (anti-TNF-α) drugs provides significant improvements in many chronic inflammatory diseases with common pathogenesis, including Crohn’s disease, ankylosing spondylitis and psoriasis. However, during these treatments, paradoxically, cutaneous side effects such as psoriasis can be seen. Although its pathophysiology is well understood, it is thought that TNF-α blockade triggers locally excessive interferon-α production in predisposed subjects and causes psoriatic lesions. In this case report, we present a 50-year-old female patient with ankylosing spondylitis and Crohn’s disease who used adalimumab and then infliximab and developed psoriasiform lesions due to these drugs. Anti-TNF-α treatment was discontinued, and ustekinumab was started. Psoriasiform rashes improved; disease activity of ankylosing spondylitis and Crohn’s disease was suppressed. Ustekinumab may be a good option to manage ankylosing spondylitis and patients with Crohn’s disease who develop psoriasiform rashes due to anti-TNF-α drugs.

Keywords

• psoriasis
• crohn’s disease
• ankylosing spondylitis
• ustekinumab